Ankylosing spondylitis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with ankylosing spondylitis usually appear normal. Physical examination of patients with ankylosing spondylitis is usually remarkable for three areas 1)axial joints 2)peripheral joints and 3)entheses.Physical examination of AS include typical diagnostic process that includes exams and tests.The Physical examination of AS include '''Schober Test,Gaenslen Test,Chin-Brow Measurement,Chest Expansion''' and '''Range of Motion.''' | Patients with ankylosing spondylitis usually appear normal. Physical examination of patients with ankylosing spondylitis is usually remarkable for three areas 1)axial joints 2)peripheral joints and 3)entheses.Physical examination of AS include typical diagnostic process that includes exams and tests.The Physical examination of AS include '''Schober Test,Gaenslen Test,Chin-Brow Measurement,Chest Expansion''' and '''Range of Motion.''' | ||
==Physical Examination== | ==Physical Examination== | ||
* Physical examination of patients with ankylosing spondylitis is usually remarkable for three areas 1)axial joints 2)peripheral joints and 3)entheses. | *Physical examination of patients with ankylosing spondylitis is usually remarkable for three areas 1)axial joints 2)peripheral joints and 3)entheses. | ||
===Appearance of the Patient=== | |||
*Patients with ankylosing spondylitis usually appear normal. | |||
=== '''Vital Signs''' === | |||
* Vital signs are within normal limits in patients with AS. | |||
=== Cervical spine === | |||
* Patient with ankylosing spondylitis(AS) shows forward stooping of the thoracic and cervical spine. | |||
* The degree of flexion deformity is measured by asking the patient to stand erect with heels and buttocks against a wall and to extend the neck, while keeping the mandible in horizontal position and ask the patient to touch the wall. | |||
* The degree of flexion deformity is measured by the distance between the occiput and the wall. | |||
=== Thoracic spine === | |||
* The degree of chest expansion is measured by the range of motion of the costovertebral joints and is measured at the level of the xiphoid process. | |||
* The physician must ask the patient to raise their arms beyond their heads and then ask the patient to maximal forced expiration how much they can and that is followed by a maximal inspiration. | |||
* In normal individuals the expansion is usually >2 cm. | |||
=== Schober test<ref name="pmid26273601">{{cite journal |vauthors=Yen YR, Luo JF, Liu ML, Lu FJ, Wang SR |title=The Anthropometric Measurement of Schober's Test in Normal Taiwanese Population |journal=Biomed Res Int |volume=2015 |issue= |pages=256365 |date=2015 |pmid=26273601 |pmc=4530222 |doi=10.1155/2015/256365 |url=}}</ref> === | |||
* In patients with AS Schober test is used to measure forward flexion of the lumbar spine. | |||
* Physician must ask the patient to stands erect then a point is placed at the middle of a line joining the posterior superior iliac spines, another mark is made above 10 cm in the midline then ask the patient to bends forward how much they can without bending the knees and measure the distance. | |||
* In normal individuals it is greater than 10 cm. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} |
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Overview
Patients with ankylosing spondylitis usually appear normal. Physical examination of patients with ankylosing spondylitis is usually remarkable for three areas 1)axial joints 2)peripheral joints and 3)entheses.Physical examination of AS include typical diagnostic process that includes exams and tests.The Physical examination of AS include Schober Test,Gaenslen Test,Chin-Brow Measurement,Chest Expansion and Range of Motion.
Physical Examination
- Physical examination of patients with ankylosing spondylitis is usually remarkable for three areas 1)axial joints 2)peripheral joints and 3)entheses.
Appearance of the Patient
- Patients with ankylosing spondylitis usually appear normal.
Vital Signs
- Vital signs are within normal limits in patients with AS.
Cervical spine
- Patient with ankylosing spondylitis(AS) shows forward stooping of the thoracic and cervical spine.
- The degree of flexion deformity is measured by asking the patient to stand erect with heels and buttocks against a wall and to extend the neck, while keeping the mandible in horizontal position and ask the patient to touch the wall.
- The degree of flexion deformity is measured by the distance between the occiput and the wall.
Thoracic spine
- The degree of chest expansion is measured by the range of motion of the costovertebral joints and is measured at the level of the xiphoid process.
- The physician must ask the patient to raise their arms beyond their heads and then ask the patient to maximal forced expiration how much they can and that is followed by a maximal inspiration.
- In normal individuals the expansion is usually >2 cm.
Schober test[1]
- In patients with AS Schober test is used to measure forward flexion of the lumbar spine.
- Physician must ask the patient to stands erect then a point is placed at the middle of a line joining the posterior superior iliac spines, another mark is made above 10 cm in the midline then ask the patient to bends forward how much they can without bending the knees and measure the distance.
- In normal individuals it is greater than 10 cm.
References
- ↑ Yen YR, Luo JF, Liu ML, Lu FJ, Wang SR (2015). "The Anthropometric Measurement of Schober's Test in Normal Taiwanese Population". Biomed Res Int. 2015: 256365. doi:10.1155/2015/256365. PMC 4530222. PMID 26273601.